Jose Nader v. New York Life Ins. Co.

Court of Appeals for the Sixth Circuit·Decided July 17, 2026·No. 25-3842·Unpublished

Opinion

NOT RECOMMENDED FOR PUBLICATION File Name: 26a0313n.06

No. 25-3842

UNITED STATES COURT OF APPEALS FILED FOR THE SIXTH CIRCUIT Jul 17, 2026 KELLY L. STEPHENS, Clerk ) JOSE A. NADER, M.D., ) Plaintiff-Appellant, ) ON APPEAL FROM THE ) UNITED STATES DISTRICT v. ) COURT FOR THE ) NORTHERN DISTRICT OF NEW YORK LIFE INSURANCE COMPANY, ) OHIO Defendant-Appellee. ) ) OPINION ) )

Before: CLAY, GIBBONS, and BLOOMEKATZ, Circuit Judges.

BLOOMEKATZ, Circuit Judge. Jose A. Nader has been complaining to New York Life

Insurance Company for over 20 years about how it calculates the cost-of-living adjustment for his

disability insurance payments. When he finally sued, the district court concluded the applicable

statutory and contractual limitations periods barred his claims. Nader appeals that determination.

We do not consider most of his arguments, as he did not raise them before the district court. And

we conclude that his properly raised arguments regarding the limitations periods are unpersuasive.

Accordingly, we affirm.

BACKGROUND

Because we review the district court’s dismissal at summary judgment, we recite the facts

in the light most favorable to the losing party—here, Nader—relying largely on the uncontested

documentary proof in the record. Hartman v. Thompson, 931 F.3d 471, 477–78 (6th Cir. 2019). No. 25-3842, Nader v. N.Y. Life Ins. Co.

This case is about a disability insurance policy that New York Life issued to Nader in 1991.

In his application, Nader requested a monthly benefit payment, subject to various adjustments.

New York Life issued the policy with an effective date of coverage of December 28, 1991. The

policy provided that the parties’ “entire contract” consisted of the insurance policy plus “any

attached riders or endorsements, and the attached copy of the application.” Policy, R. 1-1, PageID

39.

Relevant here is the Cost-of-Living Benefit Rider (“COLB Rider”) that issued with the

policy. Nader checked a box for “COLB 5%” when filling out his application, triggering the

inclusion of the rider with his policy. This COLB Rider continually increased Nader’s base

monthly benefit to counteract inflation. As detailed by the rider, starting after the first year of

benefits, New York Life would annually adjust a $12,000 base monthly benefit based on changes

in the Consumer Price Index for All Urban Consumers (“CPI-U”), capped at a 5% annual increase.

To effectuate these terms, New York Life would calculate Nader’s benefits by multiplying the

$12,000 monthly benefit by a factor tied to changes in the CPI-U, subject to that 5% annual cap.

But since that 5% only served as a cap, it was always plausible—even likely—that his benefits

would increase by less than that amount each year. The COLB Rider also froze once Nader turned

65, meaning his monthly payments would not increase for inflation after that point.

During a 1999 residential move, Nader lost his original copy of the policy. Accordingly,

New York Life sent him a replacement—the “true and accurate copy of the Policy” that Nader

attached to his complaint. Compl., R. 1-1, PageID 13. That copy contains the COLB Rider

discussed above.

In 2000, after experiencing several severe health issues, Nader submitted a total disability

claim under his policy. New York Life approved that claim as of February 24, 2000, and began

-2- No. 25-3842, Nader v. N.Y. Life Ins. Co.

paying the $12,000 base monthly benefit. Since then, Nader has remained disabled and thus

entitled to benefits which New York Life has continually paid. New York Life has continued

paying Nader throughout this litigation.

The parties’ dispute concerns the amount New York Life owed Nader after his first year of

payments and in each year since. They agree that the policy required a $12,000 payment in year

one. They disagree about how much that amount should have increased annually for the cost-of-

living adjustment, and how New York Life should have calculated the increase. After the first year,

New York Life adjusted Nader’s benefit under the COLB Rider’s formula, raising it to $12,408.

Nader believed he was entitled to a 5% increase to $12,600 and wrote to notify New York Life

that his payments did not reflect that amount. A New York Life customer care specialist responded

a week later, telling him that $12,408 reflected the amount due under the COLB Rider’s terms.

She explained that the company “divide[s] the current CPI-U factor by the CPI-U factor for 1999

to determine the new increase factor” each year, NYL Docs., R. 30-1, PageID 686, and that 5%

was simply the maximum annual increase the policy allowed, not a guaranteed rate. Thus, New

York Life arrived at its number by dividing the 2001 CPI-U (174.3) by the 1999 CPI-U (168.5),

which yielded an increase factor of 1.034—meaning that New York life increased the monthly

benefit by 3.4 percent, from $12,000 to $12,408.

Nader has since repeatedly disputed his cost-of-living benefit and repeatedly received the

same response from New York Life. Notably, he does not contend that New York Life is

improperly applying the COLB Rider. Instead, he argues that the COLB Rider itself was not part

of the insurance policy that he elected in 1991 because that policy, he claims, provided a fixed 5%

annual cost-of-living adjustment. Despite raising this argument to New York Life since 2002,

Nader did not sue the company until 2023 when he filed a complaint alleging that it breached the

-3- No. 25-3842, Nader v. N.Y. Life Ins. Co.

contract by limiting annual cost-of-living adjustments to changes in the consumer price index and

imposing other annual limits on cost-of-living adjustments to his benefits.

Upon New York Life’s motion for summary judgment, the district court concluded that

two separate limitations periods barred Nader’s claims. First, it considered Ohio’s limitations

period for contract claims, § 2305.06 of the Ohio Revised Code. It found that Nader had “actual

knowledge” of the COLB calculations as early as 2002, meaning the 15-year statute of limitations

period had long since run. D. Ct. Op., R. 49-1, PageID 6360. Nader made almost no limitations

arguments below. But, reading generously, the district court located two relevant sentences in

Nader’s 35-page brief: “Defendant’s procedural argument regarding Ohio’s statute of limitations

fails to acknowledge the continuing violation doctrine. Each monthly payment constitutes a

separate breach, creating a continuing violation that restarts the limitation period.” Id. (quoting

Resp. to MSJ, R. 35, PageID 5720). The district court reasoned that even “if not waived,” this

argument would fail because Nader’s complaint is not about a recurring miscalculation under the

COLB Rider’s terms. Id. at PageID 6361. Rather, Nader’s complaint takes issue with the

“continuing effects” of incorporating the rider and its formula into his insurance policy in the first

place. Id. As the district court explained, the Ohio Supreme Court does not recognize the

“continuing effects of prior violations” to save claims from Ohio’s limitations period for contract

claims. Id. (quoting State ex rel. Nickoli v. Erie MetroParks, 923 N.E.2d 588, 594 (Ohio 2010)).

Second, the district court recognized that even if Ohio’s statute of limitations did not bar

Nader’s claims, a separate contractual limitations period did.

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Jose Nader v. New York Life Ins. Co., (6th Cir. 2026).

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